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Vendor Forms

Welcome Vendors! We are now accepting vendor applications for the remainder of the 2012-2015 authorization period scheduled to end effective September 30, 2015.  Once received, application processing begins immediately and can take up to 30 days to complete.  Please be advised that all current, new and interested WIC vendors will be required to submit a new application packet for the 2015-2018 authorization period set to begin October 1, 2015.  We encourage you to visit this website for more updates as they become available.

Download Vendor Forms

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WIC Check Appeal Request form and instructions (updated 11.21.2016)

Vendor Supplies Form
Supplies order form between vendor and State of Alaska.

​Retraining Form (revised 5/2015)
This form may be used by vendors to notify us of a problem experienced with a client who does not seem to understand the WIC program rules or how to purchase the correct foods. It can also be used by a client to help us identify cashiers that may need additional training on WIC policies and procedures.

Alaska WIC Program Complaint Form
Form to fill out in case of complaint.

Food Exemption Request
This form may be used by vendors to apply for an exemption from carrying certain WIC allowed foods.

Infant Formula Approved Suppliers List
Vendors must purchase infant formula from only approved distributors.